Trastuzumab in HER2-positive Biliary Tract Cancer (BILHER)
Primary Purpose
Cholangiocarcinoma, Biliary Tract Cancer, HER-2 Protein Overexpression
Status
Completed
Phase
Phase 2
Locations
Korea, Republic of
Study Type
Interventional
Intervention
Trastuzumab
Sponsored by
About this trial
This is an interventional treatment trial for Cholangiocarcinoma focused on measuring Cholangiocarcinoma, Biliary Tract Cancer, Trastuzumab
Eligibility Criteria
Inclusion Criteria:
- The subject with disease that is not amendable to a curative treatment approach or locally advanced or metastatic or unresectable CCC with histological diagnosis
- At least one measurable(per RECIST 1.1) lesion
- Primary or metastatic tumor with HER2 positive defined on IHC2+, FISH+ or IHC3+
- ECOG Performance status 0 or 1
- At least 3 months for life expectancy Common inclusion criteria
- Men or women over 19 years at time of signing ICF
Signed Informed Consent Form
Exclusion Criteria:
- Received prior chemotherapy for advanced/metastatic disease (the adjuvant/neoadjuvant chemotherapy completed at least 6 months before enrolled will be accepted)
- Not recovery from toxicities related to any prior treatments excluding alopecia (eg, neurological toxicity to ≥ Grade 2)
- History of malignancy other than CCC within 5 years prior to screening, with the exception of malignancies with a negligible risk of metastasis or death, such as carcinoma in situ or thyroid papillary carcinoma Hematology, chemistry or organ function
- ANC < 1.5 × 109/L, or Platelet < 100 × 109/L
- Total bilirubin > 1.5 × ULN; or AST/ ALT > 2.5 × ULN (or if the tumor has expanded into the liver, > 5 × ULN); or, alkaline phosphatase > 2.5 × ULN (or > 5 × if the tumor has expanded into the liver, or > 10 × ULN if the tumor has expanded into the brain without liver,); or albumin < 2.5 g/dL
- Creatinine clearance < 60 mL/min(calculated using the Cockcroft-Gault formula) Other exclusion criteria related to IP
- History of proved congestive heart failure; angina with medication; evidence of transmural myocardial infarction on ECG; uncontrolled hypertension(systolic> 180 mmHg or diastolic> 100 mmHg); clinically significant heart valve disease; uncontrolled arrhythmia
- LVEF < 50% (calculated by cardiac sonography or MUGA)
- Subject with rest dyspnea due to metastatic tumor or other disease or who needs oxygen therapy
- Chronic or high-dose corticosteroid treatment
- Clinically significant Hearing impairment Common exclusion criteria
- History or evidence of CNS metastases
- Interstitial pneumonia or pulmonary fibrosis with symptom and exact lesion on chest X-ray
- Hearing loss
- Uncontrolled significant systemic disease (eg, infection or uncontrolled DM)
- Pregnant or lactating females
- Sexually active fertile subjects without contraception
- Treatment with other investigational therapy within 4 weeks prior to initiation of study treatment
- Radiotherapy within 4 weeks prior to initiation of study treatment (the rest at least 2 weeks after palliative radiotherapy for bone metastasis and recovery from the effects of radiation will be accepted.)
- Major surgery within 4 weeks prior to initiation of study treatment
- History of HIV and active HBV or HCV
- Previously identified allergy or hypersensitivity to components of the study treatment formulations
Sites / Locations
- Asan Medical Center
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Trastuzumab plus Gem/Cis
Arm Description
Gemcitabine 1,000 mg/m2 Day 1 and Day 8, every 3 weeks Cisplatin 25 mg/m2 Day 1 and Day 8, every 3 weeks Trastuzumab, every 3 weeks, 8 mg/kg at first cycle then, 6 mg/kg
Outcomes
Primary Outcome Measures
Response rate
Best response according to the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1
Adverse events
Adverse events graded by National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) version 4.03
Secondary Outcome Measures
Progression-free survival
Time between the initiation of chemotherapy and disease progression or death
Overall survival
Time between the initiation of chemotherapy and any cause of death
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT03613168
Brief Title
Trastuzumab in HER2-positive Biliary Tract Cancer
Acronym
BILHER
Official Title
The Pilot Study of Trastuzumab in Combination With Gemcitabine Plus Cisplatin for HER2-positive Biliary Tract Cancer
Study Type
Interventional
2. Study Status
Record Verification Date
January 2021
Overall Recruitment Status
Completed
Study Start Date
June 1, 2019 (Actual)
Primary Completion Date
November 1, 2020 (Actual)
Study Completion Date
January 4, 2021 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Changhoon Yoo
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
Trastuzumab is approved for the treatment of HER2-positive breast cancer and gastric cancer. The recent study showed that HER2 overexpression or amplification is noted about 5-15% of total biliary tract cancer patients. The aim of this study is to evaluate the efficacy and safety of trastuzumab in the combination of current standard gemcitabine plus cisplatin.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cholangiocarcinoma, Biliary Tract Cancer, HER-2 Protein Overexpression, HER-2 Gene Amplification
Keywords
Cholangiocarcinoma, Biliary Tract Cancer, Trastuzumab
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
4 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Trastuzumab plus Gem/Cis
Arm Type
Experimental
Arm Description
Gemcitabine 1,000 mg/m2 Day 1 and Day 8, every 3 weeks Cisplatin 25 mg/m2 Day 1 and Day 8, every 3 weeks Trastuzumab, every 3 weeks, 8 mg/kg at first cycle then, 6 mg/kg
Intervention Type
Drug
Intervention Name(s)
Trastuzumab
Intervention Description
Trastuzumab plus gemcitabine/cisplatin
Primary Outcome Measure Information:
Title
Response rate
Description
Best response according to the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1
Time Frame
6 months
Title
Adverse events
Description
Adverse events graded by National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) version 4.03
Time Frame
2 years
Secondary Outcome Measure Information:
Title
Progression-free survival
Description
Time between the initiation of chemotherapy and disease progression or death
Time Frame
2 years
Title
Overall survival
Description
Time between the initiation of chemotherapy and any cause of death
Time Frame
2 years
10. Eligibility
Sex
All
Minimum Age & Unit of Time
19 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
The subject with disease that is not amendable to a curative treatment approach or locally advanced or metastatic or unresectable CCC with histological diagnosis
At least one measurable(per RECIST 1.1) lesion
Primary or metastatic tumor with HER2 positive defined on IHC2+, FISH+ or IHC3+
ECOG Performance status 0 or 1
At least 3 months for life expectancy Common inclusion criteria
Men or women over 19 years at time of signing ICF
Signed Informed Consent Form
Exclusion Criteria:
Received prior chemotherapy for advanced/metastatic disease (the adjuvant/neoadjuvant chemotherapy completed at least 6 months before enrolled will be accepted)
Not recovery from toxicities related to any prior treatments excluding alopecia (eg, neurological toxicity to ≥ Grade 2)
History of malignancy other than CCC within 5 years prior to screening, with the exception of malignancies with a negligible risk of metastasis or death, such as carcinoma in situ or thyroid papillary carcinoma Hematology, chemistry or organ function
ANC < 1.5 × 109/L, or Platelet < 100 × 109/L
Total bilirubin > 1.5 × ULN; or AST/ ALT > 2.5 × ULN (or if the tumor has expanded into the liver, > 5 × ULN); or, alkaline phosphatase > 2.5 × ULN (or > 5 × if the tumor has expanded into the liver, or > 10 × ULN if the tumor has expanded into the brain without liver,); or albumin < 2.5 g/dL
Creatinine clearance < 60 mL/min(calculated using the Cockcroft-Gault formula) Other exclusion criteria related to IP
History of proved congestive heart failure; angina with medication; evidence of transmural myocardial infarction on ECG; uncontrolled hypertension(systolic> 180 mmHg or diastolic> 100 mmHg); clinically significant heart valve disease; uncontrolled arrhythmia
LVEF < 50% (calculated by cardiac sonography or MUGA)
Subject with rest dyspnea due to metastatic tumor or other disease or who needs oxygen therapy
Chronic or high-dose corticosteroid treatment
Clinically significant Hearing impairment Common exclusion criteria
History or evidence of CNS metastases
Interstitial pneumonia or pulmonary fibrosis with symptom and exact lesion on chest X-ray
Hearing loss
Uncontrolled significant systemic disease (eg, infection or uncontrolled DM)
Pregnant or lactating females
Sexually active fertile subjects without contraception
Treatment with other investigational therapy within 4 weeks prior to initiation of study treatment
Radiotherapy within 4 weeks prior to initiation of study treatment (the rest at least 2 weeks after palliative radiotherapy for bone metastasis and recovery from the effects of radiation will be accepted.)
Major surgery within 4 weeks prior to initiation of study treatment
History of HIV and active HBV or HCV
Previously identified allergy or hypersensitivity to components of the study treatment formulations
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Changhoon Yoo, MD
Organizational Affiliation
Asan Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Asan Medical Center
City
Seoul
ZIP/Postal Code
05505
Country
Korea, Republic of
12. IPD Sharing Statement
Plan to Share IPD
No
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Trastuzumab in HER2-positive Biliary Tract Cancer
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